Top Surgery Scars

Top surgery is a life-changing procedure for many individuals in the transgender and gender-diverse community. It’s a pivotal step towards aligning one’s physical appearance with their gender identity. However, like any surgery, top surgery leaves scars. In this comprehensive guide, we’ll explore everything you need to know about top surgery scars, including their types, management, and how to embrace them as part of your journey towards self-discovery and authenticity.

Introduction to Top Surgery

Top surgery, formally known as chest masculinization surgery (FTM) or breast augmentation (MTF), involves altering the chest to better align with an individual’s gender identity. For FTM individuals, this often means removing breast tissue to achieve a flatter, more masculine chest, while MTF individuals may opt for breast augmentation to create a more feminine appearance.

The decision to undergo top surgery is deeply personal and varies from person to person. For many, it’s a crucial step in their transition journey. However, it’s important to understand that top surgery, like any surgical procedure, carries the risk of scarring.

Types of Top Surgery Scars

The type and visibility of scars resulting from top surgery can vary depending on several factors, including the surgical technique used, individual healing patterns, and aftercare. Let’s explore the most common types of top surgery scars:

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1. Double Incision (DI) Mastectomy Scars (FTM)

  • Description: Double incision mastectomy is one of the most common techniques for FTM top surgery. It involves making horizontal incisions along the chest, removing breast tissue, and repositioning the nipples.
  • Scarring: DI mastectomy scars typically run horizontally across the chest, often resembling a horizontal line beneath the pectoral muscles. Nipple grafts or reduction techniques can also result in circular scars around the areolas.
  • Visibility: DI mastectomy scars are usually more noticeable initially but tend to fade and flatten over time.

2. Periareolar (Keyhole) Mastectomy Scars (FTM)

  • Description: Periareolar mastectomy, also known as keyhole surgery, involves making incisions around the areolas to remove breast tissue.
  • Scarring: Scars from periareolar mastectomy are usually circular and positioned around the areolas. They are generally less visible compared to DI mastectomy scars.
  • Visibility: These scars are typically less conspicuous, making them a popular choice for individuals who want minimal scarring.

3. Inverted-T (Anchor) Incision Scars (MTF)

  • Description: MTF breast augmentation surgery often uses an inverted-T incision technique. This involves making incisions around the areolas, vertically down to the breast crease, and horizontally along the crease.
  • Scarring: The scars from inverted-T incisions can be more extensive than those from DI or periareolar mastectomies. They create an anchor-like pattern.
  • Visibility: Initially, these scars may be more noticeable, but they tend to fade and improve with time.

4. Trans-Areolar Incision Scars (MTF)

  • Description: In some cases, MTF individuals opt for a trans-areolar incision technique, which involves incisions around the areolas to place breast implants.
  • Scarring: Scars from this technique are typically circular and positioned around the areolas.
  • Visibility: Trans-areolar scars may be less noticeable than inverted-T scars but still require proper care to minimize their appearance.
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Factors Affecting Top Surgery Scars

Several factors influence the development and visibility of top surgery scars:

1. Surgical Technique

The choice of surgical technique plays a significant role in determining the type and extent of scars. As discussed earlier, DI, periareolar, inverted-T, or trans-areolar techniques result in different scar patterns.

2. Individual Healing Response

Everyone’s body heals differently. Some individuals may have a genetic predisposition to form thicker or more noticeable scars (hypertrophic or keloid scars), while others may heal with less conspicuous scarring.

3. Aftercare and Scar Management

Proper aftercare and scar management can significantly impact the final appearance of scars. Post-operative care instructions provided by your surgeon should be followed diligently. This may include wearing compression garments, avoiding sun exposure, and using scar-minimizing products.

4. Skin Type and Color

Skin type and color can influence scar visibility. People with lighter skin tones tend to have scars that are less noticeable than those with darker skin. However, scar management remains crucial for everyone.

5. Smoking and Lifestyle Choices

Smoking and certain lifestyle choices, such as excessive alcohol consumption or poor nutrition, can hinder the body’s ability to heal and may result in more pronounced scars.

Managing and Minimizing Top Surgery Scars

While it’s impossible to completely eliminate scars, several strategies can help manage and minimize their appearance after top surgery:

1. Follow Post-Operative Instructions

Your surgeon will provide specific post-operative instructions to optimize your healing process. These may include wearing compression garments, avoiding strenuous activities, and taking prescribed medications.

2. Scar Care Products

There are various scar care products available, such as silicone sheets or gels, that can help reduce scar visibility. These products should be used as directed by your surgeon.

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3. Avoid Sun Exposure

Protecting your scars from the sun is crucial, as UV rays can darken and worsen their appearance. Use sunscreen or cover scars with clothing when exposed to sunlight.

4. Massage and Moisturize

Gentle scar massage with a moisturizing cream can promote blood flow to the scar tissue, making it softer and less noticeable. Be sure to consult your surgeon before starting any massage routine.

5. Stay Hydrated and Eat a Balanced Diet

Proper nutrition and hydration support the body’s healing process. A diet rich in vitamins, minerals, and antioxidants can aid in scar healing.

6. Consider Scar Revision Surgery

In some cases, individuals may opt for scar revision surgery to improve the appearance of their scars. This involves surgically modifying the scar tissue to make it less noticeable. However, it’s important to wait until your scars have fully matured before considering this option.

Embracing Your Top Surgery Scars

While it’s natural to be concerned about the appearance of scars after top surgery, it’s also essential to embrace them as part of your journey towards self-discovery and authenticity. Your scars are a testament to your courage and determination to live authentically. Here are some tips for embracing your top surgery scars:

1. View Scars as Badges of Courage

Instead of seeing your scars as flaws, view them as badges of courage and symbols of your journey towards self-acceptance. Each scar tells a unique story of transformation and resilience.

2. Share Your Story

Sharing your top surgery experience and the journey of healing with others can be empowering. It not only helps reduce stigma but also connects you with a supportive community of individuals who have gone through similar experiences.

3. Practice Self-Compassion

Be kind and compassionate towards yourself. It’s okay to have moments of doubt or

insecurity about your scars, but remember that they are a part of you and your unique path.

4. Seek Support

If you’re struggling with body image or self-esteem concerns related to your scars, consider seeking support from a therapist or support group specializing in gender identity and body positivity.


Top surgery scars are a natural part of the transformation process for many transgender and gender-diverse individuals. While they may initially be a source of concern, it’s crucial to remember that they are a testament to your journey towards self-acceptance and authenticity. With proper aftercare, scar management, and a positive mindset, you can minimize their appearance and embrace them as symbols of your courage and resilience. Your scars tell a unique story, and they are a reminder that you are living your truth.